Re: Post-ablation reoccurences - paper

[Guest guest]

Thanks for the information Vicky. I'm at two weeks post PVA and have had only

a few break throughs. 30 min. duration to one hr. I feel different. Stronger,

I have more energy.

I had my two week follow up today. They did a cardiac MRI and a TEE. This was

done to check they're handy work. The Dr. said let's get together in two

months and see how your doing.

Rich O

[Guest guest]

Thanks for the information Vicky. I'm at two weeks post PVA and have had only

a few break throughs. 30 min. duration to one hr. I feel different. Stronger,

I have more energy.

I had my two week follow up today. They did a cardiac MRI and a TEE. This was

done to check they're handy work. The Dr. said let's get together in two

months and see how your doing.

Rich O

[Guest guest]

Thanks for the information Vicky. I'm at two weeks post PVA and have had only

a few break throughs. 30 min. duration to one hr. I feel different. Stronger,

I have more energy.

I had my two week follow up today. They did a cardiac MRI and a TEE. This was

done to check they're handy work. The Dr. said let's get together in two

months and see how your doing.

Rich O

[Guest guest]

on Thu, 25 Jul 2002 at 15:34:33, celtic8586@... wrote :

>Thanks for the information Vicky. I'm at two weeks post PVA and have had only

>a few break throughs. 30 min. duration to one hr. I feel different. Stronger,

>I have more energy.

>I had my two week follow up today. They did a cardiac MRI and a TEE. This was

>done to check they're handy work. The Dr. said let's get together in two

>months and see how your doing.

> Rich O

Rich,

Wow, great.

I have a theory that I can't get confirmed but it makes sense to me,

that when you go back into NSR, the heart then has some years of AF-work

to undo, and that this basically requires *time* for the remaining

healthy heart cells to go through their normal turnover of regeneration

- this is probably 6 wks+ period (to several months?). They are finding

that once AF is initiated (by ectopic foci) it is largely maintained by

a " dispersion of refractoriness " (different refractory periods in

different areas) around the atria - and they know that AF itself can

cause or exacerbate this.

So my guess is that when the AF stops, the heart cells just have to have

time to turn over and " regrow " in an AF-free environment. Maybe this is

why it can take time.

Best of health to all,

Vicky

[Guest guest]

on Thu, 25 Jul 2002 at 15:34:33, celtic8586@... wrote :

>Thanks for the information Vicky. I'm at two weeks post PVA and have had only

>a few break throughs. 30 min. duration to one hr. I feel different. Stronger,

>I have more energy.

>I had my two week follow up today. They did a cardiac MRI and a TEE. This was

>done to check they're handy work. The Dr. said let's get together in two

>months and see how your doing.

> Rich O

Rich,

Wow, great.

I have a theory that I can't get confirmed but it makes sense to me,

that when you go back into NSR, the heart then has some years of AF-work

to undo, and that this basically requires *time* for the remaining

healthy heart cells to go through their normal turnover of regeneration

- this is probably 6 wks+ period (to several months?). They are finding

that once AF is initiated (by ectopic foci) it is largely maintained by

a " dispersion of refractoriness " (different refractory periods in

different areas) around the atria - and they know that AF itself can

cause or exacerbate this.

So my guess is that when the AF stops, the heart cells just have to have

time to turn over and " regrow " in an AF-free environment. Maybe this is

why it can take time.

Best of health to all,

Vicky

[Guest guest]

on Thu, 25 Jul 2002 at 15:34:33, celtic8586@... wrote :

>Thanks for the information Vicky. I'm at two weeks post PVA and have had only

>a few break throughs. 30 min. duration to one hr. I feel different. Stronger,

>I have more energy.

>I had my two week follow up today. They did a cardiac MRI and a TEE. This was

>done to check they're handy work. The Dr. said let's get together in two

>months and see how your doing.

> Rich O

Rich,

Wow, great.

I have a theory that I can't get confirmed but it makes sense to me,

that when you go back into NSR, the heart then has some years of AF-work

to undo, and that this basically requires *time* for the remaining

healthy heart cells to go through their normal turnover of regeneration

- this is probably 6 wks+ period (to several months?). They are finding

that once AF is initiated (by ectopic foci) it is largely maintained by

a " dispersion of refractoriness " (different refractory periods in

different areas) around the atria - and they know that AF itself can

cause or exacerbate this.

So my guess is that when the AF stops, the heart cells just have to have

time to turn over and " regrow " in an AF-free environment. Maybe this is

why it can take time.

Best of health to all,

Vicky

[Guest guest]

Vicky wrote :

<<So my guess is that when the AF stops, the heart cells just have to have

time to turn over and " regrow " in an AF-free environment. Maybe this is

why it can take time.>>

There was an article in the atrial fibrillation spotlight edition of Cardio

Vascular Research about this. (VOL. 54 ISSUE 2)

I only had a quick scan but from memory I think it said it takes 3 to 5 days

for electrical remodelling to recover after AFib but many months (and

sometimes never) for structural remodelling to recover.

I'm digging to the back of my brain for the numbers so they could be wrong.

--

D

[Guest guest]

<<By structural remodelling, do you mean the stretching of the heart

due to the tachycardia effect?>>

I don't have the journal (yet!) so I'm going from memory again so please

don't believe a word of this ....

For starters I think the article may have also mentioned ion channel

remodelling (I'm sure this must be related to electrical remodelling) I

guess the electrical remodelling is more about the moving of ions rather

than the protein channels??

Yes, stretching is part of the structural changes but I think there's a host

of other things too....

Cells degenerate (and hibernate / dedifferentiate) - gap junctions

disappear - fibrosis can occur - and there's a loss in atrial contractility

with time (and there will be bucket loads of other changes that don't

spring to mind too!)

<< I seem to recall someone in here

having an enlarged heart, and it getting back pretty much to normal

in 2-3 years after his afib was gotten under control. My hazy

recollection is that this was the most likely outcome rather than it

not correcting.>>

I'm talking way over my head and I would like to read the journal in full (a

few times!) before I'm confident about what I'm saying. I think many of

the structural changes are reversible but some aren't (e.g. I think fibrosis

is hard to get rid of)

The abstract of the article is probably this one...

http://www.elsevier.com/gej-ng/10/13/52/99/28/30/abstract.html

but the whole journal is full of great stuff so it may well be something

else in the same volume

the whole contents can be viewed here...

http://www.elsevier.com/gej-ng/10/13/52/99/28/show/toc.htt

All the best

--

D (33, Leeds, UK)

Paroxysmal AF for 24 hours every 16 days

[Guest guest]

<<By structural remodelling, do you mean the stretching of the heart

due to the tachycardia effect?>>

I don't have the journal (yet!) so I'm going from memory again so please

don't believe a word of this ....

For starters I think the article may have also mentioned ion channel

remodelling (I'm sure this must be related to electrical remodelling) I

guess the electrical remodelling is more about the moving of ions rather

than the protein channels??

Yes, stretching is part of the structural changes but I think there's a host

of other things too....

Cells degenerate (and hibernate / dedifferentiate) - gap junctions

disappear - fibrosis can occur - and there's a loss in atrial contractility

with time (and there will be bucket loads of other changes that don't

spring to mind too!)

<< I seem to recall someone in here

having an enlarged heart, and it getting back pretty much to normal

in 2-3 years after his afib was gotten under control. My hazy

recollection is that this was the most likely outcome rather than it

not correcting.>>

I'm talking way over my head and I would like to read the journal in full (a

few times!) before I'm confident about what I'm saying. I think many of

the structural changes are reversible but some aren't (e.g. I think fibrosis

is hard to get rid of)

The abstract of the article is probably this one...

http://www.elsevier.com/gej-ng/10/13/52/99/28/30/abstract.html

but the whole journal is full of great stuff so it may well be something

else in the same volume

the whole contents can be viewed here...

http://www.elsevier.com/gej-ng/10/13/52/99/28/show/toc.htt

All the best

--

D (33, Leeds, UK)

Paroxysmal AF for 24 hours every 16 days

[Guest guest]

on Fri, 26 Jul 2002 at 23:29:14, Driscoll

wrote :

>but the whole journal is full of great stuff so it may well be something

>else in the same volume

>

>the whole contents can be viewed here...

>http://www.elsevier.com/gej-ng/10/13/52/99/28/show/toc.htt

Shame the abstract here of Haissaguerre's contribution doesn't actually

have any words in the abtract !! (Medline doesn't help)

Fascinating also if you look at the co-authors of Haissaguerre's paper

(Stanley Nattel and Maurits Allessie) and then look what else they have

written about (incl the paper you indicated).

I have this feeling that Haissaguerre and his friends are going to find

the " true " cause of AF before too many years has gone by. Surely such a

low success rate with drugs means that they are only addressing

side-issues?

Best of health to all,

Vicky